| NPI | 1437305968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704283503) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 160910-9) |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2011-06-03 |